risk communication strategies for public health preparedness

[10, 65] Often, emergency risk communication and messaging strategies will reach children through their caregivers. Public health disaster research: Surveying the field, defining its future. In addition, our description of risk communication activities does not represent the totality of any states efforts in the area. We now highlight risk communication activities that are particularly innovative strategies for reaching at-risk populations. However, as evidenced by our evaluation (including the literature review, the compendium, and our site visits), many barriers to effective risk communication remain, in part because of limited resources to enable specific tailoring to meet the needs of such a diversity of at-risk groups. (2004). Oklahoma also uses a top-down approach to risk communication practices. Once the acute stage of a disaster has subsided, communications can focus on after-action reports and other evaluation activities, including sharing experiences and lessons with other counties and states. They also learned that it helps to distribute flyers at the places where people frequent (e.g., Wal-Mart). Use Adobe Acrobat Reader version 10 or higher for the best experience. Are cultural differences among non-dominant group members of the United States significant when attempting to communicate health and safety information during a public health emergency? In addition, training through exercises and drills that include risk communication for at-risk populations may improve response to future disasters. Different actors must fulfill their responsibility according to their roles and keep the communication network running. What can we learn from existing emergency preparedness efforts that might specifically support ASPEs role in the implementation of the PAHPA and enhance emergency preparedness for at-risk populations? Such motivations can serve to demystify recommendations by suggesting contextual considerations. Identifying the points of convergence serves as a means for making sense of these interacting arguments, which leads to forming a consensus on the uncertain issue [8] (p. 17). At the beginning of the outbreak, the Wuhan government did not infuse a scientific risk communication into decision making and regarded the outbreak as a common public health issue instead of an emergency without a precise investigation and consensus about the epidemiological characteristics of COVID-19. In the risk communication of COVID-19, some cases have shown that experts or the government failed to utilize understandable explanations about the epidemiological characteristics of the outbreak, the scientific principles in the prevention measures, and the curative effect of therapeutic activity. Box 2138, Santa Monica, CA 90407-2138. A Fact Sheet for People who are Deaf or Hard of Hearing, Are You Ready? Due to the knowledge gap, experts and laypeople tend to perceive risks in different ways and tend to use different terms to discuss them [41]. Public Law 101-336. As such, these findings provide a sense of how some local and state planners approach risk communication to address the needs of at-risk populations in emergencies. Academic Medicine, 82(8), 792-796. Some of this latter effect may have been due to limiting the provider resources to just those specifically giving guidance on risk communication. Representatives are available 24/7 to answer questions in English and Spanish, Monday through Friday, 8 a.m. to 8 p.m. Eastern time (ET). Oklahoma uses a 211 phone line to make information available statewide. The sites selected for our study were California, Florida, the Metropolitan Washington Area, and Oklahoma (see Table 1). It should be noted, however, that there was often considerable overlap among these categories, particularly between disabled and chronic medical conditions and between elderly and chronic medical conditions. Mileti DS, Fitzpatrick C. Communication of public risk: its theory and its application. Though a large body of research exists on public health emergency risk communication, only a small portion of that literature addresses vulnerable populations, and most citations are primarily descriptive in nature, leaving very few that offer empirical support for specific public health messaging strategies for use with vulnerable populations. Health aspects of disaster preparedness and response. It represents external communication. In fact, state and local government websites are legally obligated to provide equal access to information for PWD under the ADA (http://www.ada.gov/websites2.htm; http://www.section508.gov). (2007). The message-centered approach offers scientific and systematic methods to achieve convergence and to avoid asymmetric information around issues of risk. HHS defines the needs of at-risk individuals on the basis of five functional areas (shown below in italics). In addition to peer-reviewed literature, we also reviewed selected statutes, regulations, and other related government or organizational reports. In each of the sites visited, this same pattern was found, with sites targeting the natural disasters most common to their specific locations. Government officials are often frustrated by what they perceive to be inaccurate public perceptions of risk and unrealistic demands by the public for risk reduction [43] (p. 1). Oklahoma Weather Alert Remote Notification (OK-WARN) is a program developed in partnership with the Oklahoma Departments of Emergency Management and Rehabilitative Services, the National Weather Service, and other organizations to disseminate emergency messages via email and pagers to those who are deaf or hard-of-hearing. 224265). Where specified, emergencies were most commonly natural disasters. Another challenge is the difficulty of getting TV stations to provide ASL interpreters for the deaf. [(accessed on 15 February 2020)]; Risk Communication: A Handbook for Communicating Environmental, Safety, and Health Risks. Training for PWD. The crisis and emergency risk communication (CERC) field is defined by the Centers for Disease Control and Prevention (CDC) as, an effort by experts to provide information to allow an individual, stakeholder, or an entire community to make the best possible decisions about their well-being within nearly impossible time constraints and help people ultimately to accept the imperfect nature of choices during the crisis (CDC, 2002). The literature points to vulnerability assessments as a key part of formative research in the pre-event phase. We chose sites that represented disparate regions of the United States and had varied concentrations of urban or rural areas. Site visits. Finally, Internet-based messaging can also be frequently updated to reflect the often fast-changing circumstances surrounding a public health emergency. Ability to Engage the Audience. Table 1 shows the functional areas addressed by type of vulnerable populations represented, where an X indicates that at least one reference addressed both the vulnerable population and the functional area. Nor did we examine the effectiveness of new technology approaches for reaching at-risk populations. For Phase 3 review, four team members divided up resources flagged as all-stars. The guidance asked states to develop plans to meet the specific needs of at-risk populations, which included people with disabilities (PWD), people with serious mental illness, minority groups, non-English speakers, children, and senior citizens. Retrieved December 17, 2008, from http://www.orau.gov/cdcynergy/. People who consult on issues of at-risk populations. Commission on Risk Perception and Communication, Commission on Behavioral and Social Sciences and Education, Commission on Physical Sciences Mathematics and Resources & National Research Council. Henderson, J.N., et al. Collaborate and coordinate about risk with credible information sources. Specifically, lead state agencies within the California Department of Public Health, such as the Public Health Emergency Preparedness Office and the Office of Emergency Services, provide broad guidance to the local agencies on how to deal with emergency situations, and they monitor how the agencies follow those guidelines. [71] Several citations addressed an additional functional area, such as mental health[38, 46, 62, 65] or evacuation. CDC is working with state and local health officials to identify people who may have been in contact with individuals who have tested positive for monkeypox, so they can monitor their health. The Florida Statewide Disability Coordinator: (1) works with the health department and the Centers for Independent Living to learn how best to communicate with consumers of those agencies; (2) establishes procedures to provide effective communication within shelters; and (3) works with each county to establish contact with ASL interpreters who could be available in shelters during an emergency. This representation of RAND intellectual property is provided for noncommercial use only. CARF's CARF Guide to Accessibility: The CARF Guide to Accessibility[9] details the requirements that organizations must meet to successfully provide an environment that is accessible to individuals with disabilities. Additionally, there is evidence to suggest that some vulnerable populations may prefer to rely on social networks to receive information and to guide decision making during a public health emergency. Enhanced training for those delivering messages about the special needs of different at-risk populations may increase trust among members of these populations. 539-598). As initially presented, the guidance was organized around Focus Areas, one of which specifically related to risk communication and health information dissemination (CDC & HHS, 2004). In addition, training through exercises and drills that include risk communication for at-risk populations may improve response to future disasters. Heatwaves and public health in Europe. The goal was not to systematically review each resource, but instead to identify key exemplars that could be the focus of a more intensive review. Nevertheless, these community partnership approaches are consistent with the priorities for risk communication in the CDC guidance. In addition, involving these representatives in the development and review of communication materials can ensure that messages are appropriately crafted. Upon the closer inspection of the Phase 2 review, it was determined that 32 resources failed to satisfy our definitions of PHEP, vulnerable populations, or risk communication. Fundamentals for establishing a risk communication program. This is the first pandemic of its kind in the age of social media. 2, pp. (1995). (1988). Oak Ridge, TN: Oak Ridge National Laboratory. (2004). |203 met Criterion. (2007). These practices are consistent with an overarching conclusion of the literature review: To achieve effective emergency risk communication, offer frequent messages in multiple modes that are locally and personally relevant. In particular, risk communicators may have the instinct to tell people what they should know, not recognizing that some of that information is obvious or widely known. These findings highlight the need for communicating about risk through appropriate channels and media before, during, and after emergencies and public health disasters (McGough, Frank, Tipton, Tinker, and Vaughan, 2005). Some of the methods of interaction were to play windy bingo and hurricane jeopardy, activities that were well-received. A meta-analytic review of tailored print health behavior change interventions. Prehospital and Disaster Medicine, 19(1), 10-20. They employed a consulting firm to run focus groups by telephone with professionals representing their key groups: Native Americans, immigrants and refugees, minorities, homeless and low-income populations, PWD, and senior citizens. Having at-risk population representatives involved in planning will facilitate message development to meet the specific needs of different groups. Following the message-centered approach, it was found that the Wuhan government did not infuse a scientific risk communication into policy decision, the local government stalled reporting and handled the information publicity in an ambiguous way which undermined public perception associated with COVID-19, and the authorities failed to treat it with the inherent uncertainty and different levels of risk perception of COVID-19, which worsened the circulation of rumors and led to public panic to some extent. In closing, an impressive variety of risk communications were identified through a targeted search and compiled into the accompanying compendium. Wingard, J.R., Leahigh, A.K., et al. (2002). For this report, we present our findings within the context of guidance provided to the states by the CDC for renewing cooperative agreements, which provide funds to strengthen states public health emergency preparedness (PHEP) capacity and build capability. They then conduct focus groups to make sure that the translation actually conveys the intended message. Involving at-risk populations in the planning process. Thus, we propose an expanded definition for the purposes of this report: At-risk individuals are those who have, in addition to their event-related medical needs, social and structural needs that may interfere with their ability to access or receive medical care, prepare for an emergency, and take appropriate measures (e.g., evacuate, shelter-in-place, etc.) In Wuhans case, a doctor named Zhang Wenhong said frankly, You are unable to understand what I am saying definitely, because we read different books. Once the review research team conducted a pilot test of the DAF to ensure inter-rater reliability regarding consistency of data abstraction and to determine whether the categories adequately captured data from the literature, the remaining citations were divided among the team for full review. However, use of registries comes with a number of challenges. Any delay will likely lead to unexpected consequences. Share lessons learned across organizations and geographic regions. One mechanism that facilitates dissemination of risk communication messages in California includes contracting with disability organizations to leverage resources. 2007 report[12] aims to describe the nations progress toward achieving successful emergency preparedness (all hazards). The Power of Effective Communication. Audio/visual and pictorial displays can have great impact. Spence, P.R., et al. Subsequent analysis focused on the dimensions upon which specific all-star resources were seen to excel. Established the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities. literature on emergency preparedness risk communication and public health messaging strategies; the compilation of educational and outreach materials for emergency preparedness communication with at-risk populations; and site visits in three states and the Washington, DC area to identify gaps in the practice of risk communication with at- During Phase 2 review, each resource was reviewed by a randomly assigned team member, and catalogued data were double-checked. In addition to the general public, health care and other community providers are often the target audience for risk communication that occurs prior to an event. Weather reporters as spokespersons. A research conclusion cited by Xinhua News Agency indicates that a preliminary study shows that Chinese patent medicine Shuanghuanglian can inhibit the novel coronavirus. This wont be the last pandemic, says Viswanath. Buckley C. Chinese Doctor, Silenced after Warning of Outbreak, Dies form Coronavirus. J Expo Anal Environ Epidemiol. Including children with disabilities in exercises and drills. Sites selected for study. This form needs Javascript to display, which your browser doesn't support. This tool has high utility but because it is difficult to obtain such information for the majority of people at-risk, its reach is limited. However, as noted above, emergency risk communication must also be culturally competent. This tailoring is generally performed at the CBO or agency level rather than by the state and is consistent with findings from the compendium, where we found that non-government organizations often specifically tailored message content to specific at-risk populations (e.g., transportation for those who are mobility impaired or sheltering for those with guide dogs). Gershon, R.R.M., et al. (2006). Ng, A.T. (2005). However, there is limited knowledge about how to best communicate with at-risk populations in emergencies, a group that is a particular focus of the Pandemic and All-Hazards Preparedness Act (PAHPA) of 2006 (P.L. These websites, known to the authors through their previous work on the topic, were selected as supplemental search venues given their specific focus on risk communication to ensure no relevant content was missed and to validate the search strategy used in the larger databases. [(accessed on 1 February 2020)]; Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., Ren R., Leung K.S.M., Lau E.H.Y., Wong J.Y., et al. Risk communication must be culturally competent in addition to being offered in languages appropriate for vulnerable populations. Moreover, informants during our site visits told us that this continues to be a gap. The desirability of such strategies is supported by the results of our literature review, which identified community-based participatory approaches to message development as especially promising. Response at the provincial level: Hubei Province activated II Level Response for Emergency. Report from a regional meeting of countries of South East Asia; Bangkok, Thailand, 21-23, November 2005. Spreading what amounts to conspiracy theories can have the impact of making people cynical and less likely to comply with official recommendations, which are especially necessary right now. Media use and information needs of the disabled during a natural disaster. [28, 30, 46] School-based communication strategies offer an opportunity to reach both children and their caregivers; school curricula may be an effective venue in which to promote risk communication for children that is tailored to their developmental abilities,[66] and school nurses are an important ally in emergency risk communication for children.[10]. A risk communication model for food regulatory agencies in modern society. While translation is an obvious first step towards effective risk communication with non-English speakers, several studies we reviewed indicated that translation is not enough. (2006). In this section, we summarize what we learned from the sites as possible actions that could be taken to address the various types of barriers and what they see as opportunities for future risk communication. Cannot address the consequences of a public health emergency without including risk communication, Cannot address only risk perception without addressing risk communication, Cannot describe a preparedness training program (though may describe the results of a training exercise), Cannot address only inter-agency communication without addressing communication to the public, Vulnerable populations are specifically and substantially referenced in the title and/or abstract. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 2(3), 175-185. (2007). Decision making needs to be based on constant risk communication. ), Communicating Risks to the Public. Many resources were directed at the disabled and children, with smaller but still sizeable numbers targeting the elderly and those with chronic medical conditions. Oklahoma has exercised most aspects of its response plans, including risk communication. 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